Suan Prung Psychiatric Hospital

On Friday we were able to visit the psychiatric hospital in Chiang Mai. When the pharmacists were giving us an overview of the hospital they mentioned that one of the biggest issues patients run into when they leave the hospital, is the community accepting them back in due to stigma. It was interesting to me that alcoholism was one of the top issues they have found in this area. They also mentioned that over the years the top 5 psychiatric disorders have remained the same. The only difference being where they rank. The top 5 psychiatric disorders include; schizophrenia, anxiety, depression, bipolar disorder and alcohol abuse. Which is very similar to what we find to be part of the top 5 in the United States.

In the pharmacy they had a form that reminded everyone what medications, when combined can be dangerous to the patient. It was known as the fatal drug interaction sheet. If the doctor wrote a prescription to give a patient medications that were warned against on the fatal interaction sheet, they would need to sign the form and give their reasoning for why they chose the therapy. What I found to be interesting is that there is no where for the patient to sign to acknowledge that they are aware of the dangers that may present. It is all based on the trust the patient has for the doctor.

I thought that it was cool that they offered mail order services at this hospital. This is mainly for patients who do not have easy access to the hospital. For certain medications that need monitoring patients would need to at least go to a nearby clinic to get their labs checked occasionally. For example with clozapine every so often they would need to get their white blood cells checked and then this information would be sent to the psych hospital. This way the psych hospital feels comfortable and confident sending them a new prescription in the mail. I thought this was an awesome way to make it easier for those who may not have quick access to the hospital.

They also mentioned that they can test compliance this way because they know exactly when the patient left the hospital with their psychiatric medication and when the patient requests for a refill on their medication. When speaking to the pharmacists regarding adherence they mentioned that it is difficult. They have found that when a patients mood starts to improve they stop the medication because they believe they are cured. In response they counsel on the importance of talking medications as prescribed.

We were able to visit a female and male ward as well as the ICU section of the psychiatric hospital. The ward consisted of a few big rooms with a bunch of beds. No one had their own room and they don't seem to have many problems with their patients being in an open space like this. When I was trying to imagine patients being in this setting back home I could not imagine it going over well.

The male ward we visited dealt with patients above 50 with the primary diagnosis being psychosis. They mentioned that a lot of the men struggle with insomnia. To help with this the men are allowed to go to the gated area where they are exposed to a lot of sun light during the day to help with their circadian rhythm at night time.

Patients who are smokers are forced to quit cold turkey at this hospital. There is no smoking allowed there and unfortunately they currently do not have nicotine replacement therapy available at the hospital for their patients.

It was very interesting to see what kinds of techniques and tricks they use to make sure things run smoothly at this hospital. I had a great time on this visit! 


Thanks for reading,
Desiree